Pregnancy at a Time that is Happy and Healthy for You (PATH4YOU)

The PATH4YOU Model

The PATH4YOU Model is a three-tiered intervention that combines best practices in 1) universal pregnancy intention screening, 2) comprehensive contraceptive counseling and decision support and 3) same-day contraceptive method access, including long-acting reversible contraception (LARC). To mitigate biased and coercive counseling and prescribing practices, the PATH4YOU team will work with providers and community partners to refine and provide patient-centered tools for pregnancy intention screening and contraceptive decision support. The project aims to help providers develop skills, capacity and supply chain to provide same-day contraceptive access by training clinicians in quick-start protocols and implant and intrauterine device (IUD) insertions.

Infant and Maternal Mortality

Infant and maternal morbidity and mortality are especially poor in Indiana due to many factors. Both infant and maternal mortality disproportionately impact low-income women and women of color. Unintended pregnancies tend to have worse outcomes, including preterm birth, low birth weight and infant death. Family planning and contraceptive care are an often-overlooked element of healthy pregnancy planning.

Through PATH4YOU, women can receive reproductive health counseling as well as contraception at no or low cost. Reproductive counseling through PATH4YOU includes discussions of pregnancy intention for anyone of reproductive age as well as a discussion of contraceptive options. The goal is to make sure patients are aware of every option available to them, as well as side effects, cost and efficacy.

Commitment to Reproductive Justice

Structural racism, reproductive coercion, and social and financial disadvantage serve as challenges to developing responsible and responsive contraceptive programming that meets the needs of racially and financially marginalized communities. In recent years, for example, efforts to expand access to LARC have raised reproductive justice concerns with regards to public health and policy strategies that ‘target’ minority and low-income women. These efforts can result in coercive messaging and counseling practices that ‘push’ LARC onto these populations over other methods.

Because of these concerns, PATH4YOU aims to utilize a reproductive justice framework and community engagement to develop non-coercive, comprehensive contraceptive access programming. PATH4YOU will prioritize reproductive justice throughout this project in several ways. This includes presenting all contraceptive options, emphasizing shared decision-making and creating and engaging a diverse community advisory board throughout the planning, implementation and evaluation of the project.

Mutual trust between clinicians and patients is especially important when discussing reproductive health. It is imperative that providers are aware of implicit biases and how to avoid coercive practices. The PATH4YOU approach will address these to help providers engage in shared decision-making and continue to be a trusted source of health care for their communities.

Team Leaders

PATH4YOU includes a diverse team of healthcare providers and individuals passionate about quality, reproductive care for all. The multidisciplinary team includes physicians, nurses and midwife experts in contraception, reproductive health, adolescent care, shared decision-making and equity.